Provider Demographics
NPI:1508632340
Name:RAMIN AZARM LCSW P.C.
Entity Type:Organization
Organization Name:RAMIN AZARM LCSW P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMIN
Authorized Official - Middle Name:ADRIAN
Authorized Official - Last Name:AZARM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:631-618-5940
Mailing Address - Street 1:450 WAVERLY AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-1555
Mailing Address - Country:US
Mailing Address - Phone:631-618-5940
Mailing Address - Fax:
Practice Address - Street 1:450 WAVERLY AVE STE 11
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-1555
Practice Address - Country:US
Practice Address - Phone:631-618-5940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty